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1700273448

NPI Code Detail

MEDICARE: AMY KATHRYN CALDWELL MD

MEDICARE: AMY KATHRYN CALDWELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	01086252A	IN
2	207VC0300X	Complex Family Planning Physician	01086252A	IN
3	390200000X	Student in an Organized Health Care Education/Training Program
4	207V00000X	Obstetrics & Gynecology Physician	036.148878	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000001585894	OTHER	IN	ANTHEM PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700273448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY KATHRYN CALDWELL MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE # MC2050
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637
Country	:	US
Telephone Number	:	773-834-0598
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2015
Last Update Date	:	09/15/2025

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Directions to “ AMY KATHRYN CALDWELL MD” Practice Location

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